How much rates vary
Facilitymedian $525 · 10th to 90th $372 to $2,884Professionalmedian $389 · 10th to 90th $316 to $513
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $4,897.79 | Facility | None | $331.13 | $478.63 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $467.74 | Professional | None | $331.13 | $346.74 | $467.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $645.65 | Facility | None | $371.54 | $380.19 | $645.65 |
BCBS Michigan Setting Professional Modifier None Typical Low $75.86 Median $380.19 Typical High $537.03 | Professional | None | $75.86 | $380.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $676.08 | Professional | None | $234.42 | $354.81 | $676.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $371.54 Median $1,023.29 Typical High $4,897.79 | Facility | None | $371.54 | $1,023.29 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $537.03 | Professional | None | $338.84 | $457.09 | $537.03 |
Priority Health Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $524.81 | Professional | None | $204.17 | $354.81 | $524.81 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $489.78 | Professional | None | $316.23 | $398.11 | $489.78 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $173.78 Typical High $234.42 | Professional | 52 · Reduced service | $165.96 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $93.33 | Professional | 53 · Discontinued | $66.07 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $263.03 Typical High $354.81 | Professional | 54 · Surgery only | $245.47 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $245.47 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $229.09 | $245.47 | $331.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $169.82 Typical High $239.88 | Professional | 52 · Reduced service | $162.18 | $169.82 | $239.88 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $95.50 | Professional | 53 · Discontinued | $66.07 | $67.61 | $95.50 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $363.08 | Professional | 54 · Surgery only | $245.47 | $257.04 | $363.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $72.44 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $72.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $47.86 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $338.84 |
Where Michigan sits
The same service costs 5.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 30th of 51
$389
AK $1,148TX $219
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.